Joanne, 60 years old, was admitted to intensive care with severe community acquired pneumonia. After several days of instability, she began to improve. Her only daughter, Mary kept a vigil at her side, sleeping in the waiting room overnight. On day 5, Joanne woke up and communicated with daughter. Mary decided to go home for a rest. While she was gone, during a dose change in noradrenaline, from 6.0 to 5.0 mcg/min, an error was made. The decimal point was omitted and Joanne was commenced on 50 mcg/min of noradrenaline. Soon after, she went into ventricular fibrillation and was not able to be resuscitated. The dose error was
discovered late in the cardiac arrest. Mary has been rung by the nursing staff and asked to come back urgently to the hospital. She does not know that her mother has died. Please explain what has occurred and answer her questions as best you can.
Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.